Mesenteric tissue oxygenation status on the development of necrotizing enterocolitis

Background. Necrotizing enterocolitis (NEC) is an important cause of morbidity and mortality in preterm infants. There is limited data about the role of mesenteric oxygenation status during the first enteral feeding. Therefore, the aim of this study was to determine the mesenteric tissue oxygen saturation values before, during and after the first enteral feeding and to evaluate the effect of these values on the development of NEC in preterm infants. Methods. A total of 105 preterm babies with ≤ 32 gestational weeks were included in this prospective study. The continuous monitoring of the mesenteric tissue oxygenation status was performed before, during and 3 hours after the first feeding by near-infrared spectroscopy (NIRS). Results. The mean gestational week and birth weight of the study group were 28.8±2.1 weeks, and 1215±387 g, respectively. The first enteral feeding was started at 2.4±1.4 days with breast milk in 85% of infants. A total of 12 infants (11.4%) developed NEC (66% stage II, 34% stage III). The mean mesenteric tissue oxygen saturation levels of the infants that developed NEC were significantly lower both before and one hour after feeding (56.1±3.4 vs. 34±8.8, and 47.4±3.3 vs 37.8±10.9, respectively) compared with infants that did not develop NEC. Conclusions. Lower mesenteric tissue oxygenation values measured before, and one hour after enteral feeding was associated with NEC development. We suggest that lower mesenteric tissue oxygenation during continuous monitoring of first enteral feeding may be used to predict NEC development during follow-up

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1. Schat TE, van der Laan ME, Schurink M, et al. Abdominal near-infrared spectroscopy in preterm infants: a comparison of splanchnic oxygen saturation measurements at two abdominal locations. Early Hum Dev 2014; 90: 371-375.

2. Frost BL, Modi BP, Jaksic T, Caplan MS. New medical and surgical insights into neonatal necrotizing enterocolitis: a review. JAMA Pediatr 2017; 171: 83- 88.

3. Wu SF, Caplan M, Lin HC. Necrotizing enterocolitis: old problem with new hope. Pediatr Neonatol 2012; 53: 158-163.

4. Chen AC, Chung MY, Chang JH, Lin HC. Pathogenesis implication for necrotizing enterocolitis prevention in preterm very-low-birth-weight infants. J Pediatr Gastroenterol Nutr 2014; 58: 7-11.

5. Bozzetti V, Paterlini G, Bel FV, et al. Cerebral and somatic NIRS- determined oxygenation in IUGR preterm infants during transition. J Matern Fetal Neonatal Med 2016; 29: 443-446.

6. Dani C, Corsini I, Generoso M, Gozzini E, Bianconi T, Pratesi S. Splanchnic tissue oxygenation for predicting feeding tolerance in preterm infants. JPEN J Parenter Enter Nutr 2015; 39: 935-940.

7. Corvaglia L, Martini S, Battistini B, Rucci P, Faldella G, Aceti A. Splanchnic oxygenation at first enteral feeding in preterm infants: correlation with feeding intolerance. J Pediatr Gastroenterol Nutr 2017; 64: 550-554.

8. Martini S, Aceti A, Beghetti I, Faldella G, Corvaglia L. Feed-related splanchnic oxygenation in preterm infants with abnormal antenatal Doppler developing gut complications. J Pediatr Gastroenterol Nutr 2018; 66: 755-759.

9. Cortez J, Gupta M, Araram A, Pizzino J, Sawhney M, Sood BG. Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm infants. J Matern Fetal Neonatal Med 2011; 24: 578-582.

10. Schat TE, Heida FH, Schurink, et al. The relation between splanchic ischemia and intestinal damage in necrotizing enterocolitis. Arch Dis Child Fetal Neonatal Ed 2016; 101: F533-F539.

11. Schat TE, Schurink M, van der Laan ME, et al. Near-infrared spectroscopy to predict the course of necrotizing enterocolitis. PLoS One 2016; 11: e0154710.

12. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 1986; 33: 179-201.

13. Nino DF, Sodhi CP, Hackam DJ. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Nat Rev Gastroenterol Hepatol 2016; 13: 590-600.

14. Gay AN, Lazar DA, Stoll B, et al. Near infrared spectroscopy measurement of abdominal tissue oxygenation is a useful indicator of intestinal blood flow and necrotizing enterocolitis in premature piglets. J Pediatr Surg 2011; 46: 1034-1040.

15. Patel AK, Lazar DA, Burrin DG, et al. Abdominal near-infrared spectroscopy measurements are lower in preterm infants at risk for necrotizing enterocolitis. Pediatr Crit Care Med 2014; 15: 735-741.

16. Bora R, Mukhopadhyay K, Saxena AK, Jain V, Narang A. Prediction of feed intolerance and necrotizing enterocolitis in neonates with absent end diastolic flow in umbilical artery and the correlation of feed intolerance with postnatal superior mesenteric artery flow. J Matern Neonatal Med 2009; 22: 1092- 1096.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: 6
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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